


Love, Of a Kind

by compo67



Series: Punzel Verse [28]
Category: Supernatural RPF
Genre: Angst, Angst and Feels, Childhood Trauma, Depression, Drugs, Family Issues, Forgiveness, Graphic Depictions of Illness, HIV/AIDS, Heavy Angst, Hiding Medical Issues, Implied/Referenced Child Abuse, Implied/Referenced Domestic Violence, M/M, Major Illness, Medical Jargon, Medical Trauma, Poetry, Siblings, Therapy, Timestamp, Trauma, Twins
Language: English
Status: Completed
Published: 2017-06-04
Updated: 2017-06-04
Packaged: 2018-11-08 20:34:32
Rating: Mature
Warnings: No Archive Warnings Apply
Chapters: 1
Words: 4,295
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/11089413
Author URL: https://archiveofourown.org/users/compo67/pseuds/compo67
Summary: Long term effects of HIV medications can include: lipodystrophy, insulin resistance, increases in cholesterol or triglycerides; decreases in bone density, liver damage, and lactic acidosis. Side effects that seem mild may be a sign of more serious medical problems or complications that require treatment and/or hospitalization.Maybe Tristan fucked up.Maybe possibly in more ways than one.





	Love, Of a Kind

 

One.

Brand Name: Atripla

Efavirenz + Tenofovir disoproxil fumarate + emtricitabine. Used to reduce the activity of an enzyme called reverse transcriptase. May help to slow down or stop HIV-infected cells from producing new viruses. One tablet once daily taken orally on an empty stomach. Dosing at bedtime may improve the tolerability of nervous system symptoms. 

Common side effects: dizziness, insomnia, skin rash, abnormal dreams, headaches, muscle aches, nausea and vomiting.

 

Two

Brand Name: Odefsey

Emtricitabine + rilpivirine hydrochloride + tenofovir alafenamide fumarate. Used to decrease the amount of HIV in the body and may help lower HIV complications. One tablet once daily with a meal. Do not miss a dose. The amount of virus in the blood may increase if the medicine is stopped even for a short amount of time. The virus may develop a resistance to Odefsey and become harder to treat. Store Odefsey in its original container at room temperature. Keep away from moisture and heat. Keep container tightly closed.

Common side effects: muscle pain, weakness, stomach pain, nausea and vomiting, uneven heart rate, dizziness, loss of appetite, flu symptoms, cold sores. 

 

Three

Brand Name: Epzicom

Abacavir + lamivudine. Nucleoside reverse transcriptase inhibitors--NRTIs. Helps decrease and slow down the amount of HIV in the body. One tablet once a day with or without food. Continue to take all medications and doses exactly as prescribed by a doctor. Do not skip doses. Stopping for even a short time and then restarting the drug increases the chance of developing a serious and potentially fatal allergic reaction. Do not stop treatment. Be sure you have easy access to medical care. This may increase the risk of certain infections or autoimmune disorders. 

Common side effects: fever, rash, nausea, vomiting, diarrhea, stomach pain, fatigue, body aches, shortness of breath, cough, sore throat, dizziness. 

 

Four

Brand Name: Ziagen

Abacavir.

 

Five

Brand Name: Rescriptor

Delavirdine. 

 

Six

Brand Name: Sustiva

Efavirenz.

 

Seven

Brand Name: Viramune 

Nevirapine

 

Eight

Brand Name: Crixivan

Indinavir.

 

Nine

Brand Name: Invirase

Saquinavir.

 

Ten

Brand Name: Lexiva

Fosamprenavir.

 

Long term effects of HIV medications can include: lipodystrophy (fat redistribution); insulin resistance (which can lead to blood sugar level abnormalities and, possibly, diabetes); increases in cholesterol or triglycerides; decreases in bone density (which can increase the risk of fractures), liver damage, and lactic acidosis (which can lead to everything from muscle aches to liver failure). Side effects that seem mild may be a sign of more serious medical problems or complications that require treatment and/or hospitalization. 

Drug resistance is a major issue in HIV treatment. It typically occurs when HIV mutates or makes new variations of itself and can no longer be controlled by a medicine that was previously effective.

 

He fucked up.

And forgot.

Just a few of these. Here and there. 

Well, maybe not completely forgot. How could anyone forget being charged four hundred dollars for thirty pills? The drug card didn’t matter. The copay card didn’t matter. The coupon didn’t matter. Four hundred dollars for thirty days. 

That might have been manageable.

Maybe.

Probably. 

For at least ninety days. 

If he hadn’t had to fill four medications at once.

He sat and stared at the empty bottles, which only stared back at him, accusing him of misuse, mistrust, mismanagement of funds. 

How to pay for A) the meds B) the damage to his liver C) the increased viral load D) new shirts because he’d thrown up on all of his old ones at least twice E) cleaning supplies F) a new phone because he’d been throwing up so hard at three in the morning two weeks ago he dropped it into the toilet right after he managed to call Miya and belch out that he needed help before another surge of vomit and blood forced its way out of his mouth and into the bowl.

Government subsidies were cut.

Programs had been restricted.

Private and public funds dried up.

He made too much and not enough.

Bartending pays the rent, but it doesn’t pay for four thousand dollars worth of medication refills in a two week period. Helping out at the sex shop pays the groceries, but what does that matter when he can hardly keep anything down.

Miya screamed at him. Yelled at him. Cursed him. Threatened to leave and never come back.

Then she hugged him--close and hard enough for her fingertips to dip into the spaces between his ribs. She held on and cried and mumbled swear words in Japanese. 

The next morning, she left his apartment.

An hour later, she came back.

With a one week supply of three out of ten. It was the best she could do. And she wouldn’t take no for an answer or accept any bullshit about the trouble it must have caused or the price she must have paid. She doled out the pills and watched him eat a slice of bread and swallow them down. When he started to heave, she kept him focused. Throw up and she threatened to dig through the vomit and find the pills, rinse them off, and make him take them again. 

Tough love.

He lost a week’s worth of pay from both jobs. 

But he didn’t land himself a bed in the hospital.

Twenty pounds down, he started dressing in layers because A) he was so goddamn cold all the time B) no one wanted or needed to see him lankier and leaner than he’d already been like some fucking jacked up skeleton and C) it hid the map of bruises over his skin that eventually lead to liver damage and a weakened immune system.

Miracle of miracles, his hair didn’t fall out.

Miya replaced his phone. 

A source told him his brother had started therapy. 

Maybe it wasn’t exactly a source so much as his brother himself, who wrote, in a simple text, “I started therapy.”

When Tristan started, his first regimen included two NRTIs plus an INSTI, and an NNRTI. 

Somewhere along the line they added in a PI boosted with cobicistat. 

 

Eleven

Brand Name: Tybost

Cobicistat. Used to boost the levels of certain HIV protease inhibitors to control HIV infection. Take at the same time as any HIV protease inhibitor. Do not skip doses. One tablet once a day with food. 

Common side effects: dizziness, weight loss, severe tiredness, muscle aches, headaches, joint pain, non-healing skin sores, signs of an overactive thyroid, heat intolerance, irregular heartbeat, bulging eyes, numbness/tingling of the hands/feet/arms/legs, vision changes, fever, chills, swollen lymph nodes, trouble breathing, irritability, unusual growth in the neck/thyroid area, difficulty swallowing/moving eyes, drooping face, paralysis, trouble speaking, persistent nausea or vomiting, stomach pain, yellowing eyes/skin, dark urine, bloody urine, hives/welts/rash, hoarseness, increased thirst, unpleasant breath odor, tightness in chest, swelling of eyelids/face/lips/hands/lower legs/feet, pain in the groin or genitals, lower back or side pain, muscle spasms, trouble concentrating, trouble sleeping, dry mouth, renal impairment, abnormal dreams, depression. 

 

That didn’t work.

Nothing seemed to work.

Except his phone. 

The words “undetectable viral load” eluded him. 

What had worked before refused to work now, except to torment him every passing second, minute, hour, day, and week with some new and tortuous side effect. No position in bed was comfortable. No position on the couch was comfortable. The only comfort he took in passing out every night by the toilet was that at least he wouldn’t have to walk crawl drag himself very far whenever it came time to regurgitate.

It feels a lot like.

The way beginning.

When taking medicine became an art. Literally ART. Antiretroviral Therapy. More than twenty-five have been approved by the FDA to treat HIV infection. One. Two. Three. Not six, he hated that one. Seven was okay. Eight did worse. Remember those non-nucleoside reverse transcriptase inhibitors? Or how about those protease inhibitors? Fusion inhibitors? CCR5 antagonists? Integrase strand transfer inhibitors? Two NRTIs plus an INSTI, an NNRTI, and/or a PI. Effective ART helps people live longer, healthier, happier lives. 

Until ART destroys the masterpiece of cells and blood held together by fragile hope and whatever could be bought on the street last minute.

Shit shit shit.

Who said this would happen? Was it his case manager? His social worker? That older man with the Bible who stands in front of the clinic every single fucking day and repeats the same nasty lines from his god damned Bible. Every time he walked past, it took everything Tristan had to refrain from spitting in his face. Positive doesn’t mean weak.

Except for now.

Tonight, he dreams of Texas.

With his head on the cool white tile of his bathroom floor, his mind drifts off to bluebells and tall grass. Humidity as it only exists in Texas seeps into the back of his neck and against sharp shoulder blades. Smudged window panes. Broken whitewashed fences. Ripped screen doors. Unlit gravel driveway. A figure on the uneven porch.

Long-lashed, kind eyes. Shaggy brown hair. Skinny legs and off-brand sneakers laced up neat and tight. 

The beauty of an imperfect world.

People feared that face, that figure, those dimples and that smile. Twins were rare. Still are. The world was invented by God, who controls the rising and the setting of the sun and made the earth flat for exploration of His divine creation.

_ The first duty of the gospel preacher is to show the nature of sin _ . 

They both had God handed to them from the rough hands of their father. They both learned the nature of sin from their mother, for her words were taut like a ligature of wire. 

His only friend.

Was his brother.

That’s all they had, each other.

How terrible to think of him so fondly when he treated him so cruelly. Words don’t even make sense anymore. He his they theirs Jared Tristan CYP3A inhibitors.

He can go about it a million times and still not understand what made him so different than his twin. They were born the same, raised the same, fed the same, beaten the same, read to the from the Bible the same. 

On his very first visit to the clinic, right after he was diagnosed, one of the regulars handed him a piece of neon yellow paper. On it was a copy of a poem. 

_ Meanwhile, your lungs collapsed, and the machine, unstrained, did all your breathing now. Nothing remained but death by drowning on an inland sea of your own fluids, which it seemed could be kindly forestalled by drugs _ . 

Isentress, generic name raltegravir. Tivicay, generic name dolutegravir. Vitekta, generic name elvitegravir. Fuzeon, generic name enfuvirtide. Selzentry, generic name ibalizumab. Pro 140. Tybost, generic name cobicistat. All of them and none of them and some of them a little at a time. Is that his cell phone ringing? Or the force of his heart rollicking against the tired edges of his rib cage? How can he tell the difference? 

His phone feels warmer than his heart.

Things are different now.

It’s not just the prezista going to his head. Or the virus in his blood.

The situation has changed. He has changed. 

That’s what he knew when the doctor wrote down the three letter acronym, the label, the marker, the ghost, their father. 

HIV.

His brother asks to meet.

Today. 

In an hour.

Near the garlic fries stand on the pier.

Outside gives them plenty of room. They won’t feel so confined. So forced. It also gives them room to yell, shoulder away, or walk it off. Whatever it might turn out to be. 

Can he stand? If he can stand, can he shower, dress, find his keys, and get into a taxi? Does he have any of that make up left? The kind he wore when he first started hanging out with Jensen. The kind that cakes on and hides bruises, bags, and broken blood vessels? Does he have the strength to peel himself off the bathroom floor--do all of that--and walk towards the front porch, through tall grass, and sit with that pair of skinny legs?

Does he have any pills left? 

Ibuprofen.

Nonsteroidal anti-inflammatory. 

Best for headaches, pain, fever, and inflammation. May have fewer side effects such as gastrointestinal bleeding. It can increase the risk of fatal heart attack of stroke, especially used on a long-term basis or taken in high doses. It may cause stomach or intestinal bleeding; do not take more than the recommended dose. 

Zoloft.

Generic name: sertraline hydrochloride. An antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs). It enhances the communication between nerve cells in the central nervous system and/or restores the chemical balance of the brain. Take exactly as prescribed, follow all directions on the prescription label. Take with or without food at the same time each day. It may take up to four weeks before your symptoms improve. Do not stop taking suddenly; withdrawal symptoms may occur. Side effects include: drowsiness, dizziness, dry mouth, sleep problems, decreased sex drive, agitation, hallucinations, fever, fast heart rate, nausea, vomiting, diarrhea, loss of coordination, fainting, low levels of sodium in the body, manic episodes. 

Today requires both the ibuprofen and Zoloft. 

There’s that tinge of a headache before he heads out. It’s been there all morning, if he’s honest, but it spikes on the way to the pier. 

He’s been working on a speech.

A series of words strung together to make sentences in a particular order to express his feelings. A verbal fort, an expressed wall of boundaries and safety and respect. Because those are all things he has every right to ask for. Not even ask for. He’s way past asking. He’s at the point of no return. Ultimatum. If he doesn’t receive the safety and respect he needs, then that’s it. 

This is it.

One little blue pill taken with food every day won’t solve everything. He was resistant, hesitant, at first in accepting the prescription. The combination of therapy and an antidepressant would help the most; both combined would allow for the most progress. 

But those side effects.

He read and researched and worried. He is the only person responsible for his body, but he is not the only body is he is responsible for. 

Ultimately, it was the nightmares that got him.

Texas. Front porch. Screen doors. 

He couldn’t be responsibly responsible for anyone else if he woke up every night at two in the morning like an irritating alarm clock went off in his chest. Right before his eyes opened from each of those nightmares he felt his muscles seize and a scream prepare for launch in the back of his throat. Even the soothing, soft, patient words from a familiar and comforting source didn’t immediately put him back to sleep. And without good sleep, everything seemed ten times more difficult. Laying out clothes, doing laundry, preparing breakfast, serving breakfast, making sure breakfast is eaten, cleaning up after breakfast, cleaning, cleaning the house, shuffling, arranging, canceling, rescheduling, ordering, picking up, dropping off. 

Fine. 

Small dose. Initial dose. Fifty milligrams. He could go up if needed, but he’d have to give it at least four to six weeks. 

It’s been three. 

No telling if anything’s much better. He wasn’t raging to have marathon sex before starting it, so no comparison there. Dry mouth, maybe, difficult to tell. Drowsiness? Tough call. Tired feeling? Don’t even get him started on being tired. Time moves forward whether he likes it or not. It requires him to be on ready at all times. 

There’s no shame in taking this pill. 

None.

He tells himself that ten times before, during, and after taking it. He would never shame anyone for taking an antidepressant. Why can’t he be that kind to himself?

Well, whatever. 

Okay, no, not whatever.

Therapy is there to try and reinforce his needs and wants. He needs to take this pill for the time being. He wants to be better at handling his past, present, and future. 

He needs to talk to his brother.

Today.

With or without the speech. 

He can’t--they can’t keep putting this off any longer. This all needs to be settled before the holidays, before everyone is busy and caught up with celebrations. He can’t go through an entire holiday season with this on his chest and entrenched in his mind. 

Poems on post-its rest inside his pockets on the drive over.

Yellow pieces of armor written by the one person who made California worth staying in. 

On the pier, he waits. 

_ Quiet as a seed, and as guarded, out walking took the shape of two people uneasy together. I had the feeling that on the anxious incline of that hill we gave the hill one reason for being. What loneliness, what privacy was in that? I know, I know there are poisons like these we have to feed each other, promises we try to hold--though how can they be contained? I wanted to give you what I could of me. To be personal, without confession. I wanted to believe in the constancy of that hill. Daylight was tiring. The air, secret, alone. I win, you said. You did, I said. So we stood there. _

Neat, clear script. 

The script that appears on checks and in journals filled with drawings of chitalpa trees.

Therapy helped that relationship. He can see why and he can see why. They can see why.

There’s no judgement for taking the antidepressant, only gentle, quiet encouragement marked by a brief pat on the back. It isn’t just his own sleep cycle disrupted by nightmares. Each of them sleep a little easier, a little deeper, three weeks into treatment. 

Palm trees--the kind that live on the beach now--aren’t native to California.

He didn’t know that until a whole year after he became a permanent resident. 

How does he do this? How does he try, start, enact forgiveness? 

_ In the story, Jesus follows the fishermen after he tells the fishermen to sail ahead. Yes, he’s anointed. Yes, he’s blessed. But what matters are his eyes, fixed on the fishermen. Then begins his walking mystery. No injury. Each step a step toward the brotherhood there in that boat in the lake. It’s as if each step is carried by that brotherhood rough in the lake. He’s hardly west as they drag him in, those fishermen, except as he kisses each of them and they, devoted (thunderstruck), kiss him back. _

He called this meeting, created it by choice, and still sits on the pier scared and anxious. 

Just like his first and last trip out from Texas. On that Greyhound bus. In that stale terminal. In that brutal shelter and on multiple barren sidewalks. 

On that couch, in that one bedroom apartment, with the too-thin walls and four flights of stairs.

Scared.

_ For the drowning, yes, there is always panic. Or peace. Your body behaving finally by instinct alone. Crossing out wonder. Crossing out a need to know. You only feel you need to live. That you deserve it. Even here. Even as your chest fills with a strange new air, you will not ask what this means. Like prey caught in the wolf’s teeth, but you are not the lamb. You are what’s in the lamb that keeps it kicking. Let it. _

“Hey, sorry I’m kinda late. Cab driver got lost.”

Focus.

Hold it together and focus.

“It’s fine.” 

“I’m… glad you texted. Really.” 

Jared looks out at the shore. Living in Santa Monica is completely different than living in Anaheim. Briefly, he wonders what life might have been like had he skipped Anaheim completely and headed to the coast instead. 

“Do you want something?” Tristan offers, his voice uneven. “Water? Pop?” 

Every Sunday night, Jared and Misha walk the pier and share a beer before heading back home and resuming their roles as parents and partners. It’s a new thing, that block of time, reserved specifically for self care and to check in with someone who isn’t Jensen but whom he still trusts.

It feels strange to think about his brother as someone to trust.

“No.” Jared shakes his head. “I’m fine. Do you want to sit or walk?”

“Sit,” Tristan sighs. “Sitting would be awesome.”

Jared remembers eating garlic fries with Jensen, before and after the kids were born. There will always be that moment in time when Jared met that disgruntled boy in a Disney uniform, holding a small, crying child closer to his chest than he realized. 

There will always be this moment in time when Jared sits beside his twin brother on the Santa Monica pier in the early evening. 

There will always be some regret.

And there will always be this one single deep breath in and deep breath out. 

“You hurt me so much. Not just when I got here. Back in… back there. You were never there when I needed you. You probably have your reasons but I really don’t care. I don’t… I still don’t understand why. Why did you hate me so much when we were kids?” 

Jared’s voice breaks there. Right there.

“I don’t know.” No, he swore he wouldn’t cry. “I don’t know why you just decided to pretend like you didn’t know me. Was I that bad?”

“N-no…”

“I’m not done,” Jared snaps. “I’m talking.”

Tristan nods. 

“You haven’t been there for me way longer than when I got to Anaheim. And you haven’t been there for me since. Tris, I can’t, I can’t even put together  _ why _ anyone would treat their sibling that way? I helped out with rent. I cleaned. I cooked. I washed. But you never took me to appointments or gave up your bed or asked me if I was okay after I spent the whole morning throwing up. You never asked about the babies or what I was going to do. You just assumed.” 

Pain digs into Jared’s stomach. Almost like a contraction. 

The words he speaks don’t reach his ears. They spill out free and without hesitation or restraint.

“I hated you for the first year. Hated how you treated me, how you lived your life, how you just didn’t fucking care what happened to me. But do you know how exhausting it is raising three kids? I didn’t have the energy to hate you. Or to think about you. And I was happy like that. Finally. I got over you and everything I left. Life without you was good.”

Push. Keep on.

“I went from crying every single goddamn day to moving out to moving in and being happy. Really, really happy. You don’t get it. I got to be mommy.”

Don’t. Pull back.

“But then you showed up. Like a shadow. And you didn’t even have the guts to face me. You did it behind my back, like I wasn’t even worth facin’. And that wasn’t enough for you. Nope. Because then you went behind my back with the one person I should be able to trust more than anyone else. You made him violate that trust. You held him to it and I know you did.”

Breathe.

Wait.

Just a second.

It’s quiet on the pier.

Jared runs a hand through his hair. “So what do you want, Tristan? Why are you here? Why the fuck are you here and what the hell made you think you deserve to be in my life again?”

Pause.

“Do you…” Jared laughs and shakes his head. “Do you want me to forgive you? Tell you it’s all good? Tell you don’t worry, I’m fine, it’s all in the past? Is what you did keeping you up at night?”

Yes.

For a moment, Jared wants to hear that yes, it does keep Tristan up at night. 

“Yes.” 

“What?” 

“Yes,” Tristan blurts out. “Yes, I want you to forgive me. Yes, I want you to tell me it’s all good. Yes, it all keeps me up at night. Jay, I’m sorry.” Muddy, dirty tears. “I want your forgiveness, I’m not gonna lie about that. I can’t… I’m not gonna say I know what you went through. But I know some of it and I’m sorry.” 

Texas. Front Porch. Screen door.

Tristan shakes underneath his baggy sweater. “I know I don’t deserve your time. Or you in general. At all. I know, please believe me, that you need time. That I… I need to show you I can do better. But if you just let me, please, just let me stay in your life, I can do it. I know I can. B-because I want to. I. Want. To be here.” 

Tall grass. 

“I changed. I mean, I’ve changed. I sobered up. I got a job. Two jobs. I met someone. I’m better, so I know I can do better. But. Please. Let me try. I’m sorry I wasn’t there. I can’t imagine. What you went through was real.”

Balcony kiss.

Anaheim sun.

Poetry.

“Why now?” Jared breathes. “Why this now?”

It’s quiet on the pier.

“Jay. I. Need to tell you something. Just listen. I’ll answer everything later. Please, just listen. Hear me out.”

Jared listens.

The last poem in his pocket-- _ I wrote, but knew that what I sought was shelter. I versed to hide from habit’s helter-skelter. I longed to love but cloaked my heart in armour. I learned too late the coward’s path to karma. Our lives are short, yet full of life and laughter, we guess, I guess, that little follows after, and should we find the ways of fate were mindless, why then regret a single act of kindness? This, too, is love, of a kind. _

Jared hands Tristan a handkerchief.

And goes with him to the hospital.

In an act of kindness.

**Author's Note:**

> my god, it happened. 
> 
> wow. the scene finally happened. holy shit. okay. well. comments would be greatly appreciated. this was incredibly difficult to write for many many reasons. i hope i delivered. i hope i wrote this right. 
> 
> poems are from Thom Gunn, Rickey Laurentiis, and Felix Dennis. lots of inspiration from "it's quiet uptown" from Hamilton.
> 
> i'm still in disbelief. it happened. wow. thank you to my betas.


End file.
